Provider Demographics
NPI:1407400468
Name:CENTURY TRANSPORT LLC
Entity Type:Organization
Organization Name:CENTURY TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:352-255-3766
Mailing Address - Street 1:5743 LOCH LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:31636-3105
Mailing Address - Country:US
Mailing Address - Phone:352-255-3766
Mailing Address - Fax:
Practice Address - Street 1:5743 LOCH LAUREL RD
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:GA
Practice Address - Zip Code:31636-3105
Practice Address - Country:US
Practice Address - Phone:352-255-3766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)